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Overdiagnosed: Making People Sick in the Pursuit of Health Paperback – January 3, 2012
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“One of the most important books about health care in the last several years.”—Cato Institute
"One of the big strengths of this relatively small book is that if you are inclined to ponder medicine's larger questions, you get to tour them all. What is health, really?... In the finite endeavor that is life, when is it permissible to stop preventing things? And if the big questions just make you itchy, you can concentrate on the numbers instead: The authors explain most of the important statistical concepts behind evidence-based medicine in about as friendly a way as you are likely to find."—Abigail Zuger, MD, The New York Times
"Overdiagnosed —albeit controversial—is a provocative, intellectually stimulating work. As such, all who are involved in health care, including physicians, allied health professionals, and all current or future patients, will be well served by reading and giving serious thought to the material presented."─ JAMA
“Everyone should read this book before going to the doctor! Welcome evidence that more testing and treatment is not always better.”─ Susan Love, MD, author of Dr. Susan Love’s Breast Book
“This book makes a compelling case against excessive medical screening and diagnostic testing in asymptomatic people. Its important but underappreciated message is delivered in a highly readable style. I recommend it enthusiastically for everyone.”─ Arnold S. Relman, MD, editor-in-chief emeritus, New England Journal of Medicine, and author of A Second Opinion: Rescuing America’s Health Care
“This stunning book will help you and your loved ones avoid the hazards of too much health care. Within just a few pages, you’ll be recommending it to family and friends, and, hopefully, your local physician. If every medical student read Overdiagnosed, there is little doubt that a safer, healthier world would be the result.”─ Ray Moynihan, conjoint lecturer at the University of Newcastle, visiting editor of the British Medical Journal, and author of Selling Sickness
“An ‘overdiagnosis’ is a label no one wants: it is worrisome, it augurs ‘overtreatment,’ and it has no potential for personal benefit. This elegant book forewarns you. It also teaches you how and why to ask, ‘Do I really need to know this?’ before agreeing to any diagnostic or screening test. A close read is good for your health.”─ Nortin M. Hadler, MD, professor of medicine and microbiology/immunology at University of North Carolina at Chapel Hill and author of Worried Sick and The Last Well Person
“We’ve all been made to believe that it is always in people’s best interest to try to detect health problems as early as possible. Dr. Welch explains, with gripping examples and ample evidence, how those who have been overdiagnosed cannot benefit from treatment; they can only be harmed. I hope this book will trigger a paradigm shift in the medical establishment’s thinking.” —Sidney Wolfe, MD, author of Worst Pills, Best Pills and editor of WorstPills.org
About the Author
Dr. H. Gilbert Welch is a renowned authority on the effects of medical screening who has appeared on The Today Show, CNN, NPR, and in the New York Times and Washington Post. He and his coauthors, Dr. Lisa M. Schwartz and Dr. Steven Woloshin, nationally recognized experts in risk communication, are professors at the Dartmouth Institute for Health Policy and Clinical Practice.
- Publisher : Beacon Press; 1st edition (January 3, 2012)
- Language : English
- Paperback : 248 pages
- ISBN-10 : 0807021997
- ISBN-13 : 978-0807021996
- Item Weight : 13.2 ounces
- Dimensions : 6.01 x 0.69 x 8.96 inches
- Best Sellers Rank: #222,723 in Books (See Top 100 in Books)
- Customer Reviews:
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My 93-year-old father has now outlived 2 doctors who insisted he needed statins because his "bad cholesterol" was abnormal even though his ratio was less than 2. And my mother died as the result of a car accident at the age of 85 after having been urged for 20 years to have a hysterectomy because there was a "shadow" on her uterus...a shadow which was discovered when they were treating her for something else. There's a whole chapter in the book on "incidentalomas" ie things high-powered imaging machines can discover when they're looking at something else. These discoveries have a way of cascading into treatments that sometimes injure and even kill people.
Every chapter resonated with me. I'd found it when I was googling to understand why my Fasting Blood Sugar of 104 was healthy in 2002, but now was considered "prediabetic." At least, it is in the U.S. where the American Diabetic Association unilaterally moved the range of normal.
All I have to do is move to Canada if I want to be cured.
What I wish was in this book, what I found missing, was Dr. Welch's guidelines for finding a doctor who will treat me like a human being, not a product to be milked for profit in a clinical factory. How can we find caring practitioners? Dr. Welch, please write another book on this very important subject.
I would highly, highly recommend that every person without a caring physician read this book. Thank you, Dr. Welch, for writing it. And I should add that Dr. Welch is not a "holistic" healer, but a practicing MD who teaches at Dartmouth Medical College. But I am so disenchanted by and even afraid of current doctors that I might seek out just such a "holistic" healer, one who actually practices that old first rule of medicine: do no harm. Better that than paying a small fortune to have a traditional doctor make you sick.
This book illustrates the potential harms of medical testing, and the potential harms of over diagnosis and treatment.
There are a number of potential medical conditions, that in many people may never cause a problem, and they could live out their life and never know and not worry. But once a potential medical problem becomes known, there is pressure to follow it, retest for it, and treat it, sometimes up to and including complicated surgeries. This pressure is felt by both the doctor and the patient. Overdiagnosis leads to unnecessary anxiety, expense, and additional testing and treatments, that would generally have been avoidable if an unnecessary test or screening test had not been ordered in the first place.
If this were part of the curriculum for high school seniors, virtually everyone could understand this important concept, and it could be part of a general curriculum in health care, a topic of major importance today in terms of health, costs, quality, etc. it should be reinforced in Medical Schools, because this is something that is not a routine part of Medical School curriculum, but this is a critically important concept for all graduating doctors before they head off into their internships.
I applaud Dr. Welch for writing this book, and note that he is an academic physician at Dartmouth. This is a somewhat contrarian view in Medicine today, so this was probably not the easiest book to write. I am thankful that he did write it though, and published it in a format easily accessible to the general public.
Top reviews from other countries
Yet the downside is that the author is often hypocritical, relying on sparse statistics to back up his argument when available and powerful anecdotes otherwise, often the case for over-diagnosis (particularly in the beginning) is not quantified adequately, despite his criticisms against the pro-over-diagnosis bodies using exactly the same systems to their end. He often comes across as too close to being against medical intervention regardless, such as his statement regarding the woman suffering from symptomatic thyroid cancer on p.140.
Overall a well written and informative read.